HPV disclosure?
May 25, 2006 6:24 AM   Subscribe

HPV etiquette: Given the ubiquity of this organism and its imperviosness to condom use, what is the etiquette for informing a new sexual partner that you have been discovered to harbor the virus, for both men and women? (Given the absence of symptoms and the inability to test in males, some sleuthing will disclose how it was discovered.) For women, if you have been diagnosed with the virus at age 20, should you be expected to disclose it to new partners indefinitely?
posted by megatherium to Society & Culture (32 answers total)

 
Don't 80% of people have HPV, or something like that? I'm not sure there's a need to bring up a condition which the overwhelming majority of the population has. It's just kind of assumed.
posted by Jairus at 6:28 AM on May 25, 2006


What?! assumed?! I would hope a perspective partner would tell me, shit, am i being naive?!
posted by killyb at 6:41 AM on May 25, 2006


Many women's immune systems fight off the virus and destroy it after a few years. Unless you know for a fact (through abnormal cell growth or otherwise) that your body continues to harbor the virus, you may not have it "indefinitely." I think HPV is something women need to be aware of for the sake of their own health, but not an STD that requires a "disclosure" discussion with partners. Liek Jairus said -- almsot everyone has it, or has had it in the past.
posted by junkbox at 6:42 AM on May 25, 2006


As a man, it doesn't matter if you tell me or not. I assume I have (or had) it already, and that everyone else does too.
posted by eas98 at 6:42 AM on May 25, 2006


Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 6.2 million Americans get a new genital HPV infection each year.

Assuming they mean 20 million in the US, that's less than 7%.

I'd say if you have visible warts (internal or external), a show-and-tell session (if possible) is in order.

Was it an abnormal Pap? In which case, I'd say disclosure is in order until you get a normal Pap.

In other cases, I wouldn't worry about it, as how do you know you still have virus?
posted by trevyn at 6:46 AM on May 25, 2006


Well, this etiquette is about to change radically, most likely, with the recent announcement of the HPV vaccine. But for now--I've never heard of anyone disclosing their status. (I won't give you the sample size of my personal study, heh, but I've never been a party to such a disclosure.) Should a man, in particular, disclose it to a female partner? Ideally, absolutely. But the problem is almost no one with HPV knows if they have a "bad" strain or a relatively benign one--not all of the genital wart-causing strains overlap with the cervical cancer-causing strains.

If one has an outbreak, well, then definitely.

Can we say: let your conscience be your guide? Disclosure would probably be a very caring thing. But also, know that it'll put you in the position of being a health educator, because lots of people still have no idea what HPV is.
posted by RJ Reynolds at 6:52 AM on May 25, 2006


trevyn, my sources seem to show a different story:


posted by Jairus at 6:53 AM on May 25, 2006


I don't have a direct answer to your question as it's something you have to come to your own decision about, but I will say that HPV is a strange STD (I work in an STD clinic) for a couple of reasons which might influence your decision.

1) It's very common, although the absolute numbers are a bit in dispute because;

2) One's body can rid itself of the infection. It used to be thought that it was by definition a chronic infection, but now it seems that most infections are successfully fought by the immune system;

3) It is transmissable (through viral shedding) even when warts are not visible (much like HSV sheds in the absence of symptoms);

4) One can self-innoculate with warts from your hand or elsewhere. (In other words, it isn't strictly an STD. This may matter in how you (or potential partners) think about your infection. If the only way you can get HPV is through "dirty sex" then that's one thing. If you can get it by shaking hands with someone with warts on their hands and then, sometime later, touching yourself, well, that's something else.)
posted by OmieWise at 7:33 AM on May 25, 2006


The answers so far seem to focus on the prevalence and ease of transmission from one carrier to another, but there is another concern. There are possibly severe consequences for women with HPV. There are types of HPV that can cause cervical cancer. True the likelihood is small but the consequences are so devastating that they merit consideration. If you are a man and you believe that you have HPV you should tell every partner that you are with. If you are a women and your most recent Pap test was abnormal you should tell you partners (women can infect other women). That is, if your doctor tells you that you no longer have HPV you can stop mentioning it, but you should inform your partners until a doctor considers you to be risk free.

The fact that many sexually active people have HPV does not absolve you of your responsibility. HPV is the the major risk factor for cervical cancer. If there is a real possibility that sex with you could some day lead to a woman having a hysterectomy , then you owe that woman the chance to make an informed opinion. You should not assume that your partner is as educated, or experienced, as you are. Also keep in mind that for most people your current partner is only the first link in a chain. You infect them, then they infect someone else, etc. . If you don't tell your partner you could be preventing a future partner of his from taking the steps necessary to keep themselves from getting cancer.
posted by oddman at 7:59 AM on May 25, 2006


I think full disclosure of any STDs--including HPV--is essential with all new sexual partners; even the drunk one night stands. Does it always happen? No, but it should.

HPV, while widespread, is a huge risk for women. And until the vaccine is made available (and even when it is), women should be told if they're about to expose themselves to the virus. From there they can make the decision if they want to continue with what they're doing.

And, though many doctors will tell you otherwise, HPV CAN spread from woman to woman through sexual contact.
posted by misanthropicsarah at 8:42 AM on May 25, 2006


Um, I would like to know if a partner had HPV or any kind of STD, and then make the decision myself whether or not that mattered to me.

Weighing the health risks is not something you can do for anyone else.
posted by Anonymous at 10:01 AM on May 25, 2006


Don't 80% of people have HPV, or something like that? I'm not sure there's a need to bring up a condition which the overwhelming majority of the population has. It's just kind of assumed.

80% of the population is not 100%. I don't have it, and I'd like to keep it that way.

Assuming that most people have it and therefore not disclosing that you might pass it on to them if they have sex with you (because you think they already have it) is really bad advice.

If you have any condition that you might infect someone with, even if it's not a more serious one like HIV, Herpes, etc..., you should still disclose this information beforehand, whether you assume they already have the condition or not.
posted by RoseovSharon at 12:19 PM on May 25, 2006


Assuming that most people have it and therefore not disclosing that you might pass it on to them if they have sex with you (because you think they already have it) is really bad advice.

My point wasn't that I wouldn't disclose HPV if I had it, it's that I wouldn't expect it to be disclosed to me by anyone else.
posted by Jairus at 12:22 PM on May 25, 2006


When something like this is so widespread and asymptomatic and undiagnosed, it is just as informative for any untested sexual partner to point out that they have no idea whether they have HPV, and that they are just assuming that they currently do not. And then let their partner weigh the health risks, because the risks are still there.

In this case, if you think that those who test positive for HPV should disclose their status, then the burden to disclose an unknown status should also be placed on the untested.
posted by unknowncommand at 12:33 PM on May 25, 2006 [1 favorite]


My point wasn't that I wouldn't disclose HPV if I had it, it's that I wouldn't expect it to be disclosed to me by anyone else.

My point was not meant to imply that you personally would not tell someone... the point is that even though this condition is widespread, not everyone has it. Those who do have it should not assume that everyone one else does, as that is an incorrect, and irresponsible assumption.
posted by RoseovSharon at 12:35 PM on May 25, 2006


It's also irresponsible to assume that one does not have it. It can be present and asymptomatic and still transmittable.
posted by OmieWise at 12:49 PM on May 25, 2006 [1 favorite]


It's also irresponsible to assume that one does not have it. It can be present and asymptomatic and still transmittable.

I'm not talking about someone assuming they themselves don't have it. It's easy enough to get tested to know if you have it or not. Even if it's asymptomatic, a simple test will determine if it's present.

Why assume anything, and why potentially put someone at risk? This attitude of assuming that just about everyone has it and that therefore no one needs to be told because they've probably already got it is quite surprising to me (and disturbing).
posted by RoseovSharon at 1:17 PM on May 25, 2006


RoseovSharon writes "This attitude of assuming that just about everyone has it and that therefore no one needs to be told because they've probably already got it is quite surprising to me (and disturbing)."

Yeah, I agree, but the issue is precisely that it's a complex problem because of the unknowns, which is a point to consider. My second comment was directed to what I took to be your tone of (almost) shocked outrage, as well as the assurance with which you stated that you didn't have the virus. The simple test to which you refer is, to my understanding: 1) only approved for women, 2) only tests for the strains of HPV which can cause cervical cancer. It's quite possible, perhaps even probable, that you might have (or have had) another strain of the virus.

I'm not saying one way or another what the questioner should do, but as in all things, I tend to think that acknowledging the complexities of the situation makes for better outcomes all around. Glossing those complexities in favor of a moral tone makes me as uncomfortable when the subject is HPV as it does when the subject is a woman's right to choose to have an abortion.
posted by OmieWise at 1:33 PM on May 25, 2006


I concur with the above sentiments that not disclosing this is disturbing. Herpes is becoming incredibly common too - does that make it OK not to disclose?

If your potential partner isn't mature enough to understand the harmfulness or lack thereof of HPV, then they probably shouldn't be a partner in the first place.

It should definitely be revealed, and doing so may save you some pain/red tape in the future. What if the person had been tested negative for it, then began a relationship with you, then picked it up? If they assumed you were clean, they might think you don't realize you have it -- maybe you don't get tested like you shoud -- maybe you cheated and picked it up and don't know yet but have passed it on -- etc etc...
posted by twiggy at 1:46 PM on May 25, 2006


My second comment was directed to what I took to be your tone of (almost) shocked outrage, as well as the assurance with which you stated that you didn't have the virus. The simple test to which you refer is, to my understanding: 1) only approved for women, 2) only tests for the strains of HPV which can cause cervical cancer.

I am a woman, so I am speaking from the point of view of a woman who would like to have a choice as to what risks she is being exposed to. Even if I am only able to rule out being exposed to the strain which causes cancer, that's a choice that I think should be up to me, not the person I am having sex with.

It's quite possible, perhaps even probable, that you might have (or have had) another strain of the virus.

Sorry, but again, this is a really broad assumption. Not everyone has multiple sex partners and therefore not everyone has had as great a chance of exposure. It is possible to know with testing, at least for women, if they have it or not.

I'm not saying one way or another what the questioner should do, but as in all things, I tend to think that acknowledging the complexities of the situation makes for better outcomes all around. Glossing those complexities in favor of a moral tone makes me as uncomfortable when the subject is HPV as it does when the subject is a woman's right to choose to have an abortion.

Not sure where you picked up on a moral tone, but my comments were about simply being a responsible person and alerting one's sex partners to the risk of a possible infection. Knowing that you have a condition and not telling someone because you assume they already have it is wrong. It's a matter of health, not morals.

For people with more serious STDs it's considered the right thing to do to let their partners know. I don't understand how this is any different. Just because it probably won't kill me and all my friends might have it doesn't mean I want to get it any more than I want to get AIDs or herpes or gonorrhea. The CDC website states that "The surest way to eliminate risk for genital HPV infection is to refrain from any genital contact with another individual." If your genitals are possibly going to give someone a disease, your partners deserve to know about, whether you think they already have that disease or not. Again, if this makes me overly moralistic, so be it.
posted by RoseovSharon at 2:08 PM on May 25, 2006


It's easy enough to get tested to know if you have it or not.

Not if you're male. No HPV tests are available for men.

I have no idea how the thread has missed this so far.
posted by mikeh at 2:13 PM on May 25, 2006 [1 favorite]


It has not been missed and was already mentioned a few times. I explained that I am a female and am speaking from a woman's perspective.
posted by RoseovSharon at 3:17 PM on May 25, 2006


Yes, but the point is that your partners most likely could not know if they were exposing you.
posted by occhiblu at 3:39 PM on May 25, 2006 [1 favorite]


(Assuming you're straight)
posted by occhiblu at 4:07 PM on May 25, 2006


And assuming you, or your partner, has ever had sex with, or had sex with someone who had sex with a female who had HPV or was uncertain or any man who had sex with either a man or a positive/uncertain woman. Even if all the women in the equation get tested, there's still a lot of certainty because there's the assumption that *all* of them in the chain have some way of reporting it to past sex partners. If you knowingly carry a bad strain, let your partner know. But even those strains do not carry the stigma of herpes because they only *may* lead to cervical cancer even if you get them.
posted by mikeh at 6:30 PM on May 25, 2006


In this scenario, mikeh, the man should be honest enough to admit that he has a high probability of being a HPV carrier because he has had many partners. He should therefore be responsible enough to inform his new partner that there is a good chance (but no way to be certain) that he carries HPV. The woman, now properly informed, can then choose to have sex with the man or not.

The man should not assume that the woman already believes that he has HPV. He should not assume that she is knowledgeable about STDs in general and HPV specifically. He should not assume that it's okay to keep quiet because most of his crowd has it.

He should be a mature and responsible adult and admit that consenting to have sex with him could place the woman's health at risk. And a woman with HPV, or who knows that she is likely to have HPV, should be mature enough to tell her prospective partner that he could be risking the health of his future partners (and wife!) by having sex with her. (Of course the same level of responsibility holds for same-sex couplings.)

Why is it so hard for those of you who don't think that a warning is merited to understand that it is simply wrong to omit important information when entering into any kind of relationship?
posted by oddman at 7:17 PM on May 25, 2006


OK, except that basically means every man who's not a virgin should give that speech, which just means every woman should assume that every non-virgin she's about to sleep with fits the above criteria.
posted by occhiblu at 8:07 PM on May 25, 2006 [1 favorite]


So if you felt like covering all your ethical bases, every time you have sex with someone new, you *should* point out that each of you probably already has, or has had, HPV, and you should stress that every woman should get an annual Pap test (plus viral test if necessary) to make sure it's not the bad kind.

Actually, that sounds like pretty good etiquette to me. Although kind of wordy for "the talk". Maybe you could just hand them a flyer, or get a bunch of fortune cookies made up.
posted by unknowncommand at 10:13 AM on May 26, 2006 [1 favorite]


"which just means every woman should assume that every non-virgin she's about to sleep with fits the above criteria"

While it is fair to say that every woman should assume that her partners are at risk for having HPV (I don't disagree with you about that), not every woman (nor every man) is as educated about STD's as the people in this discussion. That is why you should always have the courtesy to warn your partners.
posted by oddman at 7:51 AM on May 29, 2006


Sure, and if you're treating it as a courtesy, then that's great. But I don't think it's necessarily my partners' responsibility to educate me on STDs -- educating yourself is part of being a sexually responsible adult -- and I was objecting to the idea that people who have had multiple partners are "irresponsible, disturbing, wrong, or dishonest" for not mentioning that they *might* have HPV, even when there's no real reason to assume they do (that is, past sexual partners haven't tested positive).

I mean, a guy *might* get a woman pregnant. Does he need to mention that to every new partner, too? Some things about sex are just risks that you kind of assume people know. And while I'm not condoning lying if you do know you're definitely at risk, if you haven't had partners with it or don't know your status, then I don't think you need to have a consciousness-raising session about HPV with every single partner.
posted by occhiblu at 8:45 AM on May 29, 2006 [1 favorite]


RoseovSharon writes "It is possible to know with testing, at least for women, if they have it or not."

I think you are misunderstanding the test, which only tests for a few strains. It's possible to know that you don't have those strains, but not all the myriad others.
posted by OmieWise at 11:00 AM on May 30, 2006


sooo. from what you're all saying, am i correct in summarizing that:

you can get HPV and never know it, for your whole entire life.
you can get HPV from non-penetrative sex.
you can get HPV from penetrative sex with a condom.
you can get HPV from someone with no visible warts.
you can get HPV from warts on your own hand.
you can get HPV from a handshake, if it's timed right..
you can get HPV if you're a virgin.

so...

if the list of assumptons above is true, than i don't understand why anyone expects anything anyone tells them to mean dick shit. bottom line: YOU CAN GET HPV. most people do. statistics say that you will probably be one of them. some women are unlucky and get the bad kind, but all the talking in the world won't stop that.

so chicas, go get a pap smear and stop being an idiot. don't hand off the responsibility for the health of your girlie bits to your partners. they may not know, they may lie, they may be incorrect in telling you what they think is the truth. don't bother asking them to disclose their entire sexual history, because it doesn't matter anyway.

use condoms so you don't ger HIV, and take your girlie bits to the stirrups periodically so you don't get cancer (or at least catch it early). ta da!
posted by twistofrhyme at 11:27 AM on April 30, 2007 [1 favorite]


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